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At least 19 recordsLinked to original sources
PubMed1996

[Acute effect of use of the Flutter on expectoration of sputum in patients with chronic respiratory diseases].

The acute effects of use of the Flutter on expectoration of sputum were studied in patients with chronic respiratory diseases who had problems expectorating sputum. The Flutter is a handy, simple, physiotherapy device that is easy to use. Seventeen patients were enrolled in the study. For three consecutive days, the patients were asked to use the Flutter for 15 min when they had the hardest time expectorating sputum. They were also asked to measure the volume of the expectorant obtained during those 15 min and the following 30 min. Expectoration, coughing, and breathlessness were graded with visual analogue scales designed by us. Peak expiratory flow rate was also measured. For the control condition, the patients were asked to remove the stainless steel ball from the device and then to use the device as stated above on the three consecutive days immediately before or after the experimental days. Scores of "difficulty in expectoration" and "chest discomfort" were lower on the second and third experimental days than on the control days (mean+/-SE of difficulty in expectoration on the second day: 3.8+/-0.6 vs 4.4+/-0.6, p<0.05: on the third day: 3.0+/-0.5 vs 4.2+/- 0.6, p<0.02; chest discomfort on the second day: 2.9+/-0.6 vs 3.5/+-0.7, p<0.04; on the third day: 2.3+/-0.6 vs 2.9+/-0.6, p<0.01). No significant differences were noted in cough intensity, cough frequency, breathlessness, or peak expiratory flow. Sputum volume was larger on the second and third experimental days than on the control days (second day: 13.9+/-3.6 vs 11.3+/-3.1 ml, p<0.04; third day: 13.2+/-2.8 vs 9.9+/-2.1 ml, p<0.01). We conclude that use of the Flutter can increase the expectoration of sputum and can relieve related symptoms.

Adult↗
PubMed2005

Effect of expectoration on inflammation in induced sputum in alpha-1-antitrypsin deficiency.

It is unclear how chronic expectoration influences airway inflammation in patients with chronic lung disease. The aim of this study was to investigate factors influencing inflammation in induced sputum samples, including, in particular, chronic sputum production. Myeloperoxidase, interleukin-8, leukotriene B4 (LTB4), neutrophil elastase, secretory leukoprotease inhibitor (SLPI) and protein leakage were compared in induced sputum samples from 48 patients (36 with chronic expectoration) with COPD (with and without alpha-1-antitrypsin deficiency; AATD), 9 individuals with AATD but without lung disease and 14 healthy controls. There were no differences in inflammation in induced sputum samples from healthy control subjects and from AATD deficient patients with normal lung function but without chronic expectoration (P>0.05). Inflammation in induced sputum from AATD patients with airflow obstruction and chronic sputum expectoration was significantly greater than for similar patients who did not expectorate: Interleukin-8 (P<0.01), elastase activity (P=0.01), and protein leakage (P<0.01). The presence of spontaneous sputum expectoration in AATD patients with airflow obstruction was associated with increased neutrophilic airway inflammation in induced sputum samples. The presence of chronic expectoration in some patients will clearly complicate interpretation of studies employing sputum induction where this feature has not been identified.

Adult↗
PubMed2006

Influence of rinsing and expectoration after toothbrushing on fluoride dose and ingested amount by use of conventional and children's fluoride dentifrices.

The purpose of this study was to assess the amount of ingested fluoride and the fluoride dose to which children are subjected during toothbrushing with a conventional dentifrice (1500 ppm F) and a children's dentifrice with special flavor (1100 ppm F) and evaluate the influence of rinsing and expectoration after brushing. Six brushings followed by 6 residue collections (3 per dentifrice) were performed by 42 Brazilian children (aged 20 to 30 months). The concentration of fluoride in the residues and dentifrices was determined. The amount ingested was obtained by the difference principal. 64.3% of the children did not expectorate or rinse after brushing. For both toothpastes, no significant difference was found for fluoride doses comparing children that rinsed to those that did not rinse (p > or = 0.05). When children's toothpaste was used, children who did not expectorate were exposed to a higher dose than those who did expectorate (p = 0.032). The same was not observed when conventional toothpaste (p = 0.081) was used. In conclusion, rinsing and expectoration after brushing had no influence on the dose of fluoride to which children were exposed by use of the dentifrices. However, expectoration was directly associated to the fluoride dose when the children's dentifrice was used.

Cariostatic Agents↗
PubMed2002

Improved sputum expectoration following a single dose of INS316 in patients with chronic bronchitis.

UNLABELLED: Uridine 5'-triphosphate (UTP) is a naturally occurring agonist for P2Y(2) receptors on the apical surface of ciliated respiratory epithelium. UTP stimulates salt and water transport and cilia beat frequency in human airway epithelium in vitro. Single, inhaled doses of UTP stimulate mucociliary clearance in conscious, intubated sheep and in patients with mild chronic bronchitis (smokers and former smokers), suggesting that UTP may be useful for obtaining deep-lung sputum specimens suitable for diagnostic purposes. STUDY OBJECTIVE: UTP is being developed for the cytologic diagnosis of lung cancer under the compound number INS316 Solution for Inhalation (Inspire Pharmaceuticals; Durham, NC). Its ability to improve the quality of expectorated sputum was tested in the current study. DESIGN: Placebo-controlled, double-blind, escalating two-period cross-over study. SETTING: Outpatient volunteers. PATIENTS OR PARTICIPANTS: Twenty-six patients with mild chronic bronchitis. INTERVENTION: Patients attempted to expectorate a specimen spontaneously, following a single inhaled dose of INS316 (10 to 180 mg), and following placebo. MEASUREMENTS AND RESULTS: Sputum weight, sputum cell content, spirometry, and oxyhemoglobin saturation. Only 28% of these patients were able to expectorate a macrophage-containing, deep-lung specimen spontaneously or following inhalation of placebo. In contrast, 85% of the patients were able to produce a specimen following inhalation of INS316. The average weight of the sputum expectorated was increased fourfold by placebo and 10-fold by INS316. A mild transient decrease in pulmonary function was observed following INS316 administration. CONCLUSION: A single dose of INS316 safely improves the ability of patients with mild chronic bronchitis to expectorate a deep-lung sputum specimen suitable for cytologic evaluation.

Adult↗
PubMed1990

[Expectoration disorders in patients with chronic obstructive lung diseases].

The paper is concerned with an analysis of the original data and the conception regarding the pathogenesis of expectoration alterations and correction in patients with chronic obstructive pulmonary diseases (COPD). Expectoration defects in COPD are suggested to be classified according to duration of respiratory tract clearing from sputum. The disorders of the first and second degree amenable to correction by oral and inhalation expectorants are referred to compensation stage, those of the third degree resistant to the correction to decompensation stage. Efficiency of current expectorants is comparatively assessed as well as mechanisms of their actions. An approach to expectorants administration should be differential basing on the severity of relevant impairment and aimed at adequate maintenance or recovery of the sputum discharge in COPD patients.

Ciliary Motility Disorders↗
PubMed2000

A comparison of induced and expectorated sputum for the microbiological diagnosis of community acquired pneumonia.

BACKGROUND: Sputum induction has proved useful in the diagnosis of Pneumocystis carinii pneumonia and mycobacterial infections but there are scant data on its use in the diagnosis of community-acquired pneumonia (CAP). OBJECTIVE: To better define the usage of sputum induction by hypertonic saline in the setting of CAP. METHODS: A retrospective review of records of patients admitted to a community teaching hospital in the year 1995 with a diagnosis of CAP. RESULTS: Of 492 patients admitted with CAP, 71 (14%) had attempted sputum induction. A group of 66 patients with CAP and attempted sputum collection by spontaneous expectoration was compared with this group. Sputum induction failed to yield a sample in 22 patients (31%). Forty-five of 49 patients (92%) with induced sputum had received prior antibiotics as compared to 23 of 34 patients (68%) with expectorated samples (p < 0.05), due to sputum induction often being attempted later in the hospital course. The diagnostic yield of sputum induction was 14 of 71 (20%) compared to 16 out of 66 (24%) for attempted spontaneously expectorated samples. Antibiotic therapy was changed for 5 of 34 patients (15%) who spontaneously expectorated samples and for 9 of 49 patients (18%) with successful induction. CONCLUSIONS: Sputum induction is effective in obtaining sputum in some patients with CAP who fail to expectorate a sample. Attempting induction early, preferably before starting antibiotics, may increase its diagnostic yield.

Administration, Inhalation↗
PubMed1998

A comparison of induced and expectorated sputum for the diagnosis of Pneumocystis carinii pneumonia.

STUDY OBJECTIVES: To compare the sensitivities of expectorated and induced sputum for the diagnosis of Pneumocystis carinii pneumonia (PCP). DESIGN: Retrospective review. SETTING: Academic medical center. PATIENTS: Forty-five patients diagnosed as having PCP who had direct fluorescent antibody testing for P carinii on either expectorated or induced sputum. RESULTS: Patients were stratified according to the method of sputum production (induced vs expectorated). The two groups were similar with respect to demographic characteristics, use of prophylaxis with aerosolized pentamidine, serum lactate dehydrogenase level, and arterial oxygen level. When only the initial sputum for each patient was analyzed, there was a similar sensitivity of induced sputum, positive in 10 of 18 samples (56%), and expectorated sputum, positive in 14 of 27 samples (52%) (p>0.05). CONCLUSION: There was no significant difference in the sensitivity of induced and expectorated sputum for the diagnosis of PCP when the direct fluorescent antibody method of staining was used.

AIDS-Related Opportunistic Infections↗
PubMed1992

Methods for clinical assessment of expectorants: a critical review.

The purpose of the paper is to discuss some aspects of the methods that are most appropriate for the clinical assessment of new expectorants. Expectorants are drugs devised to help in the removal of bronchial secretions. The evaluation of these drugs is aimed at demonstrating, in controlled trials, their efficacy, safety and, if possible, mechanism of action. Unfortunately, there is no universally accepted assessment technique available. Evaluation of symptoms with the use of self-reported measures is imprecise. Studies of quality of life can assist as a means of assessing the usefulness of this class of drug for patients. Lung function tests evaluate only the possible indirect effects of expectorants; the changes observed are often minor and they do not correlate with other methods of evaluation. Mucociliary clearance studies evaluate bronchial drainage by mucociliary transport and cough. They are a useful pharmacological approach but they cannot replace therapeutic trials. In vitro and ex vivo studies of bronchial secretion, while improving knowledge of the mechanisms of bronchial secretion, fail to predict the modifications of bronchial drainage produced in vivo by cough or mucociliary transport. To be considered efficient, expectorants should not only ease the removal of bronchial secretions, but also improve the patient's condition for the duration of treatment.

Animals↗
PubMed2006

[Experimental studies on antitussive, expectorant and antiasthmatic effects of extract from Citrus grandis var. tomentosa].

OBJECTIVE: To observe the antitussive, expectorant and antiashmatic effects of the extract from Citrus grandist var. tomentosa. METHOD: The cough models induced by ammonia liquor in mice and citric acid in guines pigs were used to observe the antitussive effects. The methods of phenel red execretion in mice and phlegm displacement of rats were used to investigate the expectorant effects. Bronchial asthma model induced by histamine-acetylcholine in guinea pigs was used to observe the antiasthmatic effects. RESULT: The extract from the title plant could inhibit the cough induced by ammonia in mice, decrease the frequency of cough induced by citric acid in guineas pig and prolong the latent period of cough. The extract also could obviously increase phenol red output of trachea in mice, promote expectoration in rats and prolong the latent period of asthma induced by histamine-acetylcholine in guinea pigs. CONCLUSION: The extract from C. grandis var. tomenfosa has significant antitussive, expectorant and antiasthmatic effects.

Acetylcholine↗
PubMedDate not supplied

[Metabolism of 4-carbomethoxythiazolidine chlorohydrate to cysteine through human expectorate and lung homogenates, and its action on glycoproteins of mucus].

A study has been carried out on the formation of -SH groups and of cysteine and cystine from 4-carbomethoxythiazolidin HCl through human expectorate mucus and lung homogenates. Both the expectorate and the homogenate, revealed to be able to metabolize TCM to cysteine releasing free -SH groups. The speed of cysteine formation is higher for the homogenate, but also the expectorate revealed to be very effective for the metabolization to cysteine. Furthermore it has been demonstrated that the TCM, incubated with human expectorate in presence and in absence of lung homogenate, can modify the chemical-physical characteristics of the mucus, rendering it more soluble and less viscous, i.e. displaying a mucolytic activity. These results account for the in-vitro experimental base to the observation that the product has a mucolytic activity whether administered by os or by aerosol.

Cysteine↗
PubMed1991

Liver, lung and kidney homogenates used as an activation system in mutagenicity studies of airborne particles and of expectorate and urine samples from exposed workers in a coke plant.

A comparison was made between lung and kidney homogenates on the one hand and liver S9 from rats on the other hand in order to compare their ability to activate promutagens. The Salmonella reversion assay was used on extracts of airborne particles from the top of coke oven batteries, and of expectorate and urine samples from exposed workers in the same coke plant. The contents of benzo[a]anthracene and benzo[a]pyrene in the different test solutions were measured by high-resolution gas chromatography/mass spectrometry. Both mutagens were detected in the filter extract and in the expectorates from the exposed workers but not in the expectorates from the control groups or in the urine samples. The liver S9 gave significantly higher mutagenicity than lung and kidney activation with both filter samples and expectorate and urine samples.

Adult↗